Breast Cancer Clinical Trial
Official title:
A Clinical Trial Comparing Adjuvant Clodronate Therapy vs Placebo in Early-Stage Breast Cancer Patients Receiving Systemic Chemotherapy and/or Hormonal Therapy or No Therapy
RATIONALE: Clodronate may be effective in preventing the spread of cancer to the bones and
other parts of the body. It is not yet known whether clodronate is more effective alone or
combined with chemotherapy and /or hormonal therapy in preventing metastatic breast cancer.
PURPOSE: Randomized phase III trial to determine the effectiveness of clodronate with or
without chemotherapy and /or hormonal therapy in preventing metastases in women who have
stage I or stage II breast cancer.
OBJECTIVES:
- Determine whether clodronate administered alone or in addition to adjuvant chemotherapy
and/or hormonal therapy improves disease-free survival in women with early stage breast
cancer.
- Determine whether clodronate reduces the incidence of skeletal metastases and
non-skeletal metastases in these patients.
- Determine whether clodronate improves overall and relapse-free survival in these
patients.
- Determine whether clodronate reduces the incidence of skeletal morbidity (e.g., skeletal
fractures, hypercalcemia, skeletal pain, need for radiotherapy, spinal cord compression)
in these patients.
- Investigate the relevance of serum markers of bone turnover as a prognostic factor for
the development of bone metastasis in these patients.
OUTLINE: This is a randomized, double-blind, placebo-controlled study. Patients are
stratified by age (under 50 vs 50 and over), number of positive lymph nodes (0 vs 1-3 vs 4 or
more), and hormone receptor status (estrogen receptor [ER] and progesterone receptor [PR]
negative vs ER and/or PR positive). Patients are randomized to one of two treatment arms.
Patients in both arms commence treatment within 2 weeks of randomization and continue
treatment for 3 years in the absence of bone metastasis or unacceptable toxicity. Study
medication must be continued in the case of documented visceral or soft tissue metastasis or
other event without skeletal metastasis.
Patients in both arms may also receive adjuvant chemotherapy and/or tamoxifen at the
discretion of the protocol investigator. Patients receiving hormonal therapy begin hormonal
therapy within 3-12 weeks after the last dose of chemotherapy and continue for a minimum of 5
years.
Patients who have undergone a prior lumpectomy receive adjuvant whole breast radiotherapy.
Patients who have undergone a prior mastectomy may receive radiotherapy at the investigator's
discretion.
Patients are followed every 6 months for 5 years and then annually thereafter.
PROJECTED ACCRUAL: A total of 3,323 patients will be accrued for this study within 3.5 years.
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